Minutes of the Health Commission Meeting
Tuesday, November 21, 2006
101 GROVE STREET
San Francisco, CA 94102
1) CALL TO ORDER
President Monfredini called the meeting to order at 3:15 p.m.
- Lee Ann Monfredini, President
- James M. Illig, Vice President
- Edward A. Chow, M.D.
- Roma P. Guy, M.S.W.
- David J. Sanchez, Jr., Ph.D.
- Donald E. Tarver, II, M.D.
- John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF NOVEMBER
Action Taken: The Commission approved the minutes of the November 14,
2006 Health Commission meeting with one addition. On page 12, the
following was added to Commissioner Tarver’s comments: Given that
African American children have a disproportionate morbidity, perhaps
unequal resources were justified. Bayview has among the highest home
ownership of any district in the city; hence paying through the property
tax side may be another variable considered in how resources are
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired and Commissioner Chow and Commissioner
Tarver attended the Budget Committee meeting. The Budget Committee
requested that item 3.7 be moved from the “For Approval” section of the
agenda to the “Discussion and Approval Section.”
Items for Approval
(3.1) AIDS Office-HIV Health Services –Request for approval of a
retroactive renewal contract with Patricia Sullivan Consulting, in the
amount of $141,775, which includes a 12% contingency, to provide
professional consultation services to support the Community of Color
Community Based Organizations Capacity Building Project, for the period
of September 1, 2006 through
August 31, 2007 (1 year).
(3.2) AIDS Office-HIV Health Services – Request for approval of a
retroactive renewal contract with Mission Neighborhood Health Center, in
the amount of $257,016, which includes a 12% contingency, to provide HIV
Integrated Case Management services for individuals diagnosed with HIV
or AIDS, for the period of July 1, 2006 through December 31, 2007 (1.5
(3.3) PHP-Communicable Disease Control and Prevention – Request for
approval to accept and expend retroactively a new grant from the
California Department of Health Services, in the amount of $88,582, for
the San Francisco Department of Public Health, Communicable Disease
Control and Prevention Section, to undertake pandemic influenza
emergency preparedness and response planning, for the period of May 22,
2006 to April 30, 2008.
(3.4) CHN-LHH – Resolution Authorizing the Department of Public Health,
Laguna Honda Hospital & Rehabilitation Center (LHH) to accept a gift of
a handicapped accessible van valued in the amount of $39,889, from the
Laguna Honda Hospital Volunteers Inc., for use in the transportation of
LHH residents off campus.
(3.5) CHN-LHH – Resolution Authorizing the Department of Public Health,
Laguna Honda Hospital & Rehabilitation Center to accept a gift of funds
in the amount of $10,000, to provide supplementary assistance to support
the Senior Nutrition Program.
(3.6) CHN-LHH – Request for approval of a contract modification with the
University of the Pacific School of Dentistry to increase the contract
amount by $105,000, from $174,500 to $279,500, to provide on-site dental
clinic services for the residents of Laguna Honda Hospital, for the
period of July 1, 2004 through June 30, 2009 (60 months).
Items for Discussion and Approval
(3.7) BHS – Request for approval of a contract renewal with Thunder
Road, in the amount of $165,000, which includes a 12% contingency, to
provide mental health services for children, for the period of July 1,
2006 through December 31, 2007 (1.5 years).
Secretary’s Note – a corrected contract summary sheet was submitted to
the Budget Committee.
Commissioner Tarver asked why the hourly rate for medication support
is so high. Ms. Weinstein said the rate for medication support is paying
for psychiatrists, and they are expensive. This is an allowable rate
from the State’s point of view, and the psychiatrists have justified
this rate. Commissioner Tarver asked that, for future contracts that
include medication support, staff provides information about the range
of the State’s Medi-Cal rates, and where the contractor falls within
these allowable rates.
(3.8) CHN-SFGH & LHH Facilities – Request for approval of twenty-six
(26) contract modifications with the following twenty-one (21) firms: A
& B Mechanical, Inc., Acker & Guerrero Roof Co., Inc., Agbayani
Construction, Inc., Anderson Carpet & Linoleum Sale Co., Inc., Bay City
Boiler & Engineering Co., Inc., Birds Away/Pigeons Away, City
Mechanical, Inc., William Decker & Co., Elischer Construction, Inc.,
Galindo Installation & Moving Services, McClure Electric, Inc., Mintie
Corporation, Pioneer Contractors, Inc., Pribuss Engineering, Inc.,
Robert Poyas, Inc., Rubecon General Contracting, Inc., Sierra Electric
Co., The Shooter Co., United California Glass Co., Western Roofing
Service Co. and Yerba Buena Engineering & Construction, Inc., to
increase the total combined amounts by $2,122,500, from $4,515,000 to
$6,637,500, to provide the Community Health Network intermittent,
as-needed facility maintenance services above baseline civil service
staffing, for the period of July 1, 2005 through June 30, 2007 (24
(3.9) BHS – Request for retroactive approval of a new contract with
Families First, in the amount of $155,736, which includes a 12%
contingency, to provide mental health services, for the period of
July 1, 2006 through December 31, 2007 (1.5 years).
(3.10) BHS – Request for retroactive approval of a new contract with
Chinatown North Beach Youth Services and Coordinating Center dba
Community Youth Center, in the amount of $201,600, which includes a 12%
contingency, to provide mental health services for youth and their
families, for the period of September 1, 2006 through February 29, 2007
Commissioner Chow asked if Washington High School students would be
able to access services through this contract. Sara Huang from CYC said
that these services would indeed serve students at Washington High
School. Ms. Chan Sew added that, in addition to this contract, CBHS is
providing funding to the API Wellness Center to do translation of
materials for LGBT youth and their parents. Commissioner Chow said this
is a nice follow up to the public testimony the Health Commission heard
at the meeting that was held in the Richmond.
Action Taken: The Commission approved the Budget Committee Consent
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., Director of Health, presented the Director’s
San Francisco General Opiate Treatment Program
The Opiate Treatment Outpatient Program (OTOP) at San Francisco General
Hospital Medical Center recently completed a two-day Commission on
Accreditation of Rehabilitation Facilities (CARF) visit. This will be
OTOP's third accreditation from CARF. Surveyors reviewed programmatic
and administrative domains and met with staff and patients.
At the exit interview, CARF surveyors had only four recommendations for
all twenty domains surveyed. In what the surveyors described as an
unusual step, they gave OTOP an "exemplary" rating in two areas. The
first recognized area was the creation of an enhanced network for
integrated care including psychiatric services, medical care, case
management and prenatal services. The surveyors noted their approval of
the narcotic treatment program with its comprehensive and coordinated
care as the first of its kind in any setting. OTOP was also given an
exemplary rating for working collaboratively with city, state, and
federal agencies to pioneer innovative programs — through the Mobile
Methadone Van and the Office Based Opiate Treatment (OBOT) program.
Dr. Katz stated he is proud of the program, and pleased to have others
recognize it for its excellence. SFGH shares this success with the
program’s patients and with the program’s supporting agencies including
Community Behavioral Health Services and UCSF.
Sewer Break at Ocean Beach
As a result of the heavy rains last week, Ocean Beach experienced a
sewer and untreated storm water spill, resulting in “no swimming”
postings just below the Cliff House. DPH staff reported to the site to
offer technical assistance and oversight for clean up efforts. Within 24
hours of the spill, the San Francisco Public Utilities Commission was
able to remove the "no swimming" restriction signs and reopen the beach
for public access. Tests revealed no elevated bacteria levels,
indicating that the overflow did not reach open water.
The SFPUC, in coordination with the Department of Public Works (DPW) and
Golden Gate National Recreation Areas, have cleaned most of contaminated
sand from a 100-yard section of the beach. DPW brought in three loaders
and a 10-wheeler truck to the cleanup efforts, hauling away 18
truckloads of sand. The affected promenade area where the overflow
reached was also cleaned and sterilized.
Current investigations indicate that the burst manhole cover was due to
rusted bolts unable to withstand the buildup of pressure in the Great
Highway sewer main. Since then, all sewer manhole covers in the area
have had their bolts inspected and tightened.
Non-Profit Contact Task Force Update
Commissioner Monfredini, Commissioner Sanchez and Dr. Katz met with
contractor representatives of the Human Services Network (HSN) earlier
this month. The meeting was very productive and eight action items were
agreed upon at the meeting that will encourage better dialogue between
DPH and contractors. The two most important outcomes are: 1) the
requirement that DPH program managers will meet with contractors
annually to discuss all aspects of their contract; and 2) the contract
scope of work narratives will be reduced to a single line and the target
population narrative will be replaced by a demographic chart.
In addition, other updates include:
- The Board of Supervisors hearing scheduled for November 13th was
cancelled. Dr. Katz will notify the Health Commission when a new hearing
date is scheduled.
- The vendor satisfaction survey has been reviewed by HSN. It is
expected that the survey will be mailed to contractors this week (HSN
recommended that surveys be mailed).
- Managers in Community Programs and the AIDS Office were briefed on
contractor concerns raised by HSN. Managers were trained on the
contingency and 18-month contract models. Further training for program
staff will be held soon.
Preliminary recommendations to revise the contract scope of work have
been developed. The next step is to get DPH and contractor input on a
revised scope of work.
TB Outreach and Prevention Services (TOPS) to Relocate to SFGH
Beginning in mid-December, the TB Outreach and Prevention Services
(TOPS), currently located at 1060 Howard St., will begin relocating its
operations and staff to the TB Control Clinic on the San Francisco
General Hospital (SFGH) campus.
- The following essential TOPS functions will continue to be provided at
the new site:
- Screening of clients who are homeless, especially those who are HIV+
or who need clearance for shelter or drug treatment programs
Administration of directly observed therapy (DOT)
During the transition period, clients who need to be screened as part of
a pre-employment evaluation will be redirected to their private doctor,
another clinic or any district health center. Clients who test positive
for TB will continue to be referred to the TB control Clinic at SFGH.
Screening previously done at TOPS will resume on January 16th at the new
location. Inquiries about the new schedule should be addressed to TOPS,
Shape UP SF Walking Challenge: A Prevention Strategy
Launched in early October in conjunction with Walk to School Day, the
Shape up SF Walking Challenge encourages teams to walk the length of
California over the course of 12 weeks. Teams are encouraged to take
weekly walks together — and for individual team members to walk, bike,
swim, dance, etc. on their own — with a goal of accumulating the 1016
miles of the California coastline. Though the Challenge was geared
toward after-school programs, many City departments also formed teams —
as part of the Shape Up @ Work initiative. DPH has several walking teams
participating — WIC and the Prevention Section to name a couple.
After only seven weeks, participating teams have cumulatively walked
over 50,000 miles, or two times around the globe. Participants will
likely “walk” around the globe at least three times before the challenge
ends on December 24. Teams will be invited to a closing ceremony at
Kezar Pavilion with Mayor Newsom on January 11. For more info check out:
Vote and Vaccinate Pilot Project
San Francisco was one of three communities in California — 25 across the
nation — that participated in Vote and Vaccinate, a pilot program
designed and funded by the Robert Wood Johnson Foundation to organize,
promote and implement influenza vaccination clinics within easy reach of
polling places on Election Day, November 7, 2006.
The goal was to increase the number of adults aged 50 and over in
low-income and underserved communities who received the influenza
vaccine. Four polling sites were identified to test the premise of the
program: two in the Bayview District, one in the Mission District, and
one in the Western Addition. Flu shots were offered free of charge to
voters, as well as other community members wishing to be protected
against the flu.
Dr. Katz was happy to report that DPH vaccinated 215 very grateful and
surprised voters on Election Day. DPH will be reviewing the data to see
if they reached their target audience.
Last night Dr. Katz was privileged to serve as a panelist at the
Commonwealth Club’s program entitled, Upending the Health Care Status
Quo: Universal Healthcare Plans. Dr. Katz was joined by John Graham,
Director of Health Care Studies at the Pacific Research Institute and
Helen Halpin, PhD, Director of the Center for Public Health and Policy
Studies at UC Berkeley School of Health. John Wildermuth, political
reporter for the San Francisco Chronicle, moderated a lively discussion
about health care reform, access to care, system design, funding and a
number of other local and national health care related issues.
The panel discussion will be broadcast on KQED FM sometime in the
future. Dr. Katz will inform the Commission as soon as he knows when the
program will be broadcast.
City Desk News Hour
For those Commission members who follow City government on San Francisco
Cable Channel 11, Dr. Katz is scheduled to be interviewed by Barbara
Taylor on City Desk News Hour next Thursday, November 30th. The
interview will air on the following dates and times: Thursday, 7:30
p.m.; Friday, 9 p.m.; Saturday 8 p.m.; and Sunday, 9 p.m.
- Debbi Lerman, Human Services Network, thanked the Commission,
particularly Commissioner Monfredini and Commissioner Sanchez, for the
meeting that was held on contracting problems. The meeting created a
significant opportunity for progress. A number of agreements were made
that are all very important to progress. The Human Services Network is
looking forward to working together to move progress forward.
- Commissioner Monfredini is pleased with the outcomes of the meeting
that was held between staff and Human Services Network. Everyone came to
the table willing to make change and improvements.
- Commissioner Illig asked that all of the agreements made at the
meeting with the Human Services Network be included in the minutes. No
other Department is moving in this collective and cooperative way. The
agreements are as follows:
- DPH program managers will meet with contractor staff annually to
discuss and negotiate contract development, including outcome objectives
(including those that are imposed externally), scope of work,
monitoring, certification and the menu of options to expedite
certification (i.e. multi-year contracts, 18-month contract, 12%
contingency, interim agreements and/or COLA included in the base
budget), cultural competency and exchange of data. This shall be done in
a mutually agreed upon timeframe. The meeting will take place annually
even if the contractor has a multi-year contract.
- In case of data disagreements, contractors can share their data
reports with DPH and DPH will match its data with the contractor’s data.
- Contracts Office staff will provide training to program staff in
contract options. The training will focus on the methods that DPH has
available to streamline the contract process (i.e. 18-month contract).
The training will also encompass the COOL system. Contractors will have
the opportunity to be involved in these trainings, and HSN will take
responsibility for ensuring contractor representation. Anne Okubo will
schedule training right away in each division.
- Any contract changes, including any external state or federal
mandates, must be discussed and negotiated with contractors in a timely
- The use of COOL for contract development is voluntary for
contractors, and will be combined with conversation and training.
- DPH will develop and undertake a vendor satisfaction survey. There
will be no field test for the survey. In addition to the one-time
survey, the Department will establish a mechanism under which
contractors would be able to provide feedback on their contract process
at the conclusion of every contract cycle.
- When disseminating information and proposing policy changes for
contracts, DHP will reach out to organizations and contractor
associations for feedback. Barbara Garcia’s December budget meetings are
a good model. HSN commits to sending knowledgeable representatives.
- The Department will include contractors in the process of
streamlining the cultural competency report to better measure
- Staff will report to the Budget Committee four times a year and to
the Health Commission twice a year.
- Contract Narrative Changes
a. The scope of work will be one sentence
b. Target population will be in the form of a table or chart
c. Methodology – Michelle Long has convened a committee to develop a
mock up standardized methodology. All three DPH divisions are
represented on the committee. A copy of the draft document will be sent
to all providers. She will convene a focus group with providers to
d. Objectives will be listed.
- Commissioner Chow hopes that the Department can revisit the idea of
DOT in Chinatown. This was dropped last year, and he would like to see
if it makes sense to reestablish the service.
- Commissioner Tarver asked how many people a year went to the TOPS site
that would now be seen at San Francisco General Hospital. Dr. Katz will
provide the Commission with this information.
- Commissioner Guy said that the TB program in the shelters has been
- Commissioner Monfredini said she met with Daisy Anarchy, Sex Workers
Organized for Human and Civil Rights, along with some of her colleagues,
and they are going to work together in January to address some of the
issues that were raised at the meeting.
5) PRESENTATION OF EMPLOYEE RECOGNITION AWARDS FOR NOVEMBER
Commissioner Sanchez presented the Employee Recognition Awards for
Individual Award: Burt Kirson
Nominated By: Rajesh Parekh
Laguna Honda Hospital Activity Laguna Honda
Nominated By: John Kanaley, Mivic Hirose and William Frazier
- John Chan · · ·
- Susan Lindsay · · ·
- Mariel Badiola · · ·
- Gary Burgess · · ·
- Henry Cortez · · ·
- Angela Pownall-Elizalde · · ·
- Eileen Stafsberg · · ·
- Michele Lewis · · ·
- Cheryl Landas · · ·
6) 311 CUSTOMER SERVICE CENTER UPDATE
Heidi Sieck, Acting Director, San Francisco 311 Customer Service Center,
presented an update.
What is 311?
The San Francisco 311 Customer Service Call Center will provide
comprehensive information regarding non-emergency city services. The
mission of 311 is to provide excellent customer service to citizens,
businesses and visitors and make it easier for everyone to access
government services in San Francisco.
311 Business Objectives
- Two numbers to reach the City: 3-1-1 and 9-1-1
- Answer as many questions and requests as possible on the first call to
- Improve the customer experience for citizens, business and visitors in
- Build the foundation for citywide customer service transformation.
- Be a public safety partner, providing important information during a
time of crisis as well as serve as a back up 911 Call Center facility.
- Implement analytical tools to track performance and identify areas of
improvement in both customer service and citywide service delivery.
- Provide career opportunities and be a great place to work.
Call Center Overview
The 311 Call Center will operate as a division of the General Services
Agency out of a new, fully accessible facility at One South Van Ness,
Second Floor. The facility is also a back-up 911 Call Center that will
house 911 equipment and call takers in the event that the current 911
location is ever compromised. The 311 Call Center will be equipped with
state-of-the art telecommunications and computer equipment including the
Lagan Frontlink Customer Relationship Management (CRM) application that
will be connected to all city departments and agencies. Based on 311
programs in other cities, San Francisco 311 is designed to handle 1.5
million calls annually and will operate 24 hours a day, seven days per
week starting on the public launch date.
SCHEDULE (revised October 20, 2006)
- September 1, 2006 – Call Center Construction Complete
November 3, 2006 – 25 City Staff Transition Offers Complete
November 13, 2006 – Supervisors First Day
December 4, 2006 – Customer Service Agents First Day
January 22, 2007 – Soft Launch with 28-CLEAN, 673-MUNI, 554-4000
March 2007 – Full Public Launch
- Commissioner Monfredini said this is an exciting project. The 911 call
center gets too many calls that are not emergency in nature. This is a
real selling point for San Francisco, and she will be happy to talk
- Commissioner Illig asked if the listings for direct telephone numbers
would continue. Ms. Sieck said this would be a policy decision made by
the appropriate departments. Commissioner Illig said that the Health
Department has partnerships with hundreds of non-profit contractors. He
asked if these partners would be part of the information provided by
311. Ms. Sieck said that this decision would be made by the Health
- Commissioner Illig asked how this links with the United Way’s 211. Ms.
Sieck said they have been working with 211 for the past two years to see
how to best market each product and not overlap services. Ms. Sieck said
all parties have agreed to use a quick reference guide for all 11
numbers in San Francisco, including 211, 311, 411, 511, 611, 711 and
911. Her project is also spearheading the N11 counsel, to bring all the
parties to the table.
- Commissioner Chow asked how this would fit in with health issues and
health management. It seems burdensome to have someone call the 311 call
center to get to San Francisco General Hospital. The intent here is to
have one number as a central information center, but we need to make
sure that the Health Department does not market 311 as a disease or
medical management service. Ms. Sieck said the value of 311 is that if
people call looking for a service, 311 can get them to the right place.
Ms. Kronenberg said this is a complex process. The Health Department has
surveyed staff that provides public information, and 311 and the Health
Department are in the process of determining how to best utilize the 311
project. Commissioner Chow asked for a six-month follow-up report after
311 begins in March.
- Commissioner Guy asked if we have lessons learned from Chicago and New
York and other cities that have implemented 311 regarding the health
aspect and what is this going to cost the Health Department. Ms.
Kronenberg said neither Chicago or New York has an extensive health
component—they primarily serve to transfer calls appropriately. With
regard to resources, there is a lot of preparation involved. Once the
start up period is over, it should not result in more work for
Department staff. Ms. Sieck said Chicago used 311 as the number to
report West Nile Virus. She added that the experience of other cities is
that, once 311 starts, 90% of the misdirected calls stop.
- Commissioner Tarver urged that the 311 list of resources be inclusive
of the Health Department’s vendors. As an example, the only crisis
center in San Francisco is Westside Crisis, and this is an important
resource to include in 311. Further, if the 311 project is providing
information about services, there are a number of caveats that need to
be captured and communicated. If this project is informed by consumers,
providers and other members of the public, it could be incredibly
useful. He asked what the hiring strategy and timetable is, and will
they be doing any outreach. He said that there are a variety of
vocational programs that could provide applicants. Ms. Sieck said they
are about ready to make offers to call takers. They had 1,200 applicants
for 15 slots. They hope to have 20 additional slots next year.
- Commissioner Guy asked if 311 is funded through the general fund. Ms.
Sieck said yes. The project received a $4.2 million start up allocation.
This year, for first year of operating, the budget was $4.6 million. The
annual operating budget will be approximately $7 million. Commissioner
Guy asked that the next presentation include lessons learned from other
cities, as well as lessons learned from San Francisco’s experience.
7) CONSIDERATION OF A RESOLUTION APPROVING THE HEALTH COMMISSION’S
Lee Ann Monfredini, Health Commission President, presented the Health
Commission Attendance Policy.
- Commissioner Chow recommended that the policy by amended to state that
the annual attendance report be inclusive of attendance at scheduled
Joint Conference Committee meetings and Budget Committees. The
- Commissioner Illig asked that the annual report be provided to
Commissioners. Ms. Kronenberg said that the report could be posted on
the DPH website.
- Commissioner Tarver said the Commission should consider if it wants to
incorporate the Mayor’s suggested guideline that commissioners attend 90
percent of meetings.
Action Taken: The Commission approved the Attendance Policy as modified
by commissioner Chow.
Action Taken: The Commission approved Resolution 15-06, “Approving the
Health Commission Attendance Policy,” with the amended attachment
8) PUBLIC COMMENT/OTHER BUSINESS
Secretary’s Note – public comment was taken after the approval of the
Budget Committee Consent Calendar. Public Comment was also taken in its
regular place in the agenda.
- Dr. Tompkins spoke about the issue of compliance with the agreement
that the City entered into for Parcel A of Hunters Point Shipyard. The
developer has not complied with the dust control provisions. They are
not in compliance with the asbestos requirements. No scientific studies
have been done, and he asks that the bad science stop. He asked that a
DPH compliance officer monitor the site 24-hours a day.
- Youth representatives of Chinese Progressive Association and PODER
attending the Health Commission meeting to gain exposure to the Health
Commission. They are going to present to the Health Commission next year
about the Tobacco Free Project.
9) CLOSED SESSION
A) Public comments on all matters pertaining to the closed session
John Kanaley said that Dr. Katz has done an incredible job as the
Director of Public Health. He gives him his highest commendation.
B) Vote on whether to hold a closed session
Action Taken: The Commission voted to hold a closed session.
The Commission went into closed session at 4:55. Present in closed
session were Commissioner Monfredini, Commissioner Illig, Commissioner
Chow, Commissioner Guy, Commissioner Sanchez, Commissioner Tarver and
Commissioner Umekubo and Mitchell H. Katz, MD, Director of Health.
C) Closed session pursuant to Government Code Section 54957 and San
Francisco Administrative Code Section 67.10(b)
PUBLIC EMPLOYEES PERFORMANCE EVALUATION: MITCHELL H. KATZ, M.D, DIRECTOR OF HEALTH
D) Reconvene in Open Session
The Commission reconvened in open session at 6:15 p.m.
- Possible Report on Action Taken in Closed Session (Government Code
Section 54957.1(a)2 and San Francisco Administrative Code Section
- Vote to Elect Whether to Disclose Any or All Discussions Held in
Closed Session (San Francisco Administrative Code Section 67.12(a).)
The meeting was adjourned at 6:15
Rebekah R. Varela,
Executive Secretary to the Health Commission
Health Commission meeting minutes are approved by the Commission at the
next regularly scheduled Health Commission meeting. Any changes or
corrections to these minutes will be noted in the minutes of the next